A 1 000 days to win the world


Imagine if we could improve our children’s chances of success in life – just by what we do in the first 1 000 days of their lives? That is exactly what developments in brain science and psychology tell us is possible. The first 1 000 days of a child’s life, from the moment of conception until two years, determine their development across the life course, and ultimately, their life chances.

This is a critical time when what we do – as parents, carers and society at large – will influence the rest of our children’s lives. Making sure that babies get the right kind of care, nutrition and stimulation is the best chance we have at breaking the cycles of poverty, violence, alcohol and drug abuse. It is a chance to increase the number of young people who complete and succeed at school, to reduce inequality and build a healthy future for all.

It is a unique opportunity to change the course of our country by ensuring that our youngest citizens, and the generations still to come, can reach their potential and contribute meaningfully to our society. However, if things go wrong in the first 1 000 days, it can set a child back – permanently. We know that babies and young children are more vulnerable to abuse and neglect than older children. Abused or neglected children who don’t have a healthy bond with a caring adult are more likely to struggle at school, and become victims or perpetrators of violence. Babies who are exposed to ‘toxic stress’ (prolonged activation of the body’s stress response system such as drugs and alcohol in the womb, violence in the home, or caregivers who are depressed or mentally ill) are at risk of permanent impaired brain architecture and are unlikely to cope with stress and reach their potential later in life.

So, we must start early for maximum impact. Nobel prize-winning economist, James Heckman, has shown that investments made in the early years of children’s lives will show better results in terms of developing human potential than any later investments. And this is especially true for poor or disadvantaged children.

How can we give children the best start in life?

One can do so by, focusing on well-being during pregnancy. If you think you are pregnant, visit your clinic or health-care provider to confirm as soon as possible. Do it before you are 14 weeks pregnant. If you are pregnant, visit your clinic or health-care provider regularly to receive the necessary care and information for keeping yourself and your baby healthy. Eating nutritious meals is important. Stress, depression and anxiety may affect the health of your baby. If you are feeling sad, scared, alone, are having problems with your partner or struggling financially, talk to your health-care provider, a close friend or family member and get support as soon as possible. Learn as much as you can to prepare yourself for parenthood, and join parent groups in your area. Plan ahead if you will need child-care support. Continue your regular baby clinic visits after giving birth. Ask the clinic staff to share with you how your baby is progressing and to explain how the baby’s Road-to- Health booklet will be used to watch your baby’s growth over time. Make time to sing, talk and play with your baby. This is how babies learn. Help them try new things and explore the world around them. Have fun with your baby. Encourage your baby’s father to do the same. Call on others such as family members, friends and neighbours for the support you need. In the words of the African proverb: “It takes a village to raise a child”. You can also access support through your community and government services during this critical 1 000-day period, and beyond. Broadly promote responsive and supportive caregiving.

Government and civil society organisations should provide evidence-based programmes that promote responsive and supportive caregiving such as parent-support programmes, home-visiting programmes, community-based child care; youth development, identification, referral and support of vulnerable children and families; and building networks of care for parents and caregivers.

Invest in services that offer support during the first 1 000 days. Health and other government services play a key role in supporting women, children and parents before, during and beyond this critical 1 000-day period. Investing time and resources to strengthen these services in the first 1 000 days of children’s lives is the best way to maximise their ability to grow and learn, and to shape a safe, healthy and prosperous nation.
Together, we can change the future.


Elmarie Malek is a senior lecturer in the Department of Paediatrics and Child Health, Stellenbosch University; head of General Paediatric Specialist Services, Tygerberg Hospital; and clinic lead for the Western Cape province’s 1 st 1 000 Days Initiative. Lizette Berry is a senior researcher at the Children’s Institute, University of Cape Town